Epidemic risk perceptions in Italy and Sweden driven by authority responses to COVID-19.

Understanding public risk perception is an essential step to develop effective measures reducing the spread of disease outbreaks. Here we compare epidemic risk perceptions during two different periods of the COVID-19 pandemic in Italy and Sweden. To this end, we analyzed the results of two nationwide surveys carried out in both countries in two periods characterized by different infection rates: August (N = 4154) and November 2020 (N = 4168). Seven domains of epidemic risk perception were considered: likelihood along with (individual and population) impact, preparedness, and knowledge. The role of the context and period was explored in stratified and formal interaction analyses. In both countries, we found an intensification in epidemic risk perception from August to November 2020. Being male, older and having a higher relative income were associated with a lower perception of the likelihood of epidemics, while excess mortality was marginally related to higher odds. Compared to Sweden, Italy had a higher increase in perception of likelihood and impact, and a concurrent decrease in preparedness and knowledge. The different authority response to the COVID-19 pandemic is associated with a different change over time in risk perception. Regional differences in terms of excess mortality only marginally explained differences in risk perception.

COVID-19 vaccine hesitancy in Sweden and Italy: The role of trust in authorities.

BACKGROUND: The success of vaccination campaigns against COVID-19 infection is vital for moving from a COVID-19 pandemic to an endemic scenario. We aimed to unravel the influence of the risk perception of epidemics along with individual and contextual factors on adherence to COVID-19 vaccination campaigns in Italy and Sweden. METHODS: We compared the results of two nationwide surveys carried out in August 2021 across four domains of epidemic risk perception: perceived likelihood, perceived impact on the individual and perceived individual and authority knowledge. The roles of individual and contextual determinants were also explored. RESULTS: The survey included 2144 participants in Sweden (52.3% women) and 2010 in Italy (52.6% women). In both countries, we found that trust in authorities was one of the main drivers of this process, with two-fold increased odds of being vaccinated. Being highly educated and having a higher relative income were associated with a higher adherence to the vaccination campaign (for relative income OR = 1.44, 95% CI 1.23-1.67 in Sweden and OR = 1.18, 95% CI 1.04-1.34 in Italy; for education OR = 1.90, 95% CI 1.30-2.77 in Sweden and OR = 1.47, 95% CI 1.09-1.97 in Italy), whereas a right and centre-right compared with a left and centre-left political orientation was negatively related to vaccination adherence (OR = 0.41, 95% CI 0.25-0.67 in Sweden and OR = 0.47, 95% CI 0.33-0.68 in Italy). CONCLUSIONS: Increasing trust in authorities, along with an equal global distribution of vaccine doses, can contribute to accelerating vaccination campaigns around the world and, in turn, to move towards an endemic scenario.

Do the Benefits of School Closure Outweigh Its Costs?

School closure has been a common response to COVID-19. Yet, its implementation has hardly ever been based on rigorous analysis of its costs and benefits. We aim to first illustrate the unintended consequences and side effects of school closure, and then discuss the policy and research implications. This commentary frames evidence from the most recent papers on the topic from a public-health epidemiology and disaster risk reduction perspective. In particular, we argue that the benefits of school closure in terms of reduced infection rates should be better compared with its costs in terms of both short- and long-term damage on the physical, mental, and social well-being of children and society at large.

Multiple hazards and risk perceptions over time: the availability heuristic in Italy and Sweden under COVID-19

The severe impact of global crises, such as COVID-19 and climate change, is plausibly reshaping the way in which people perceive risks. In this paper, we examine and compare how global crises and local disasters influence public perceptions of multiple hazards in Italy and Sweden. To this end, we integrate information about the occurrence of hazardous events with the results of two nationwide surveys. These included more than 4000 participants and were conducted in two different phases of the COVID-19 pandemic corresponding to low (August 2020) and high (November 2020) levels of infection rates. We found that, in both countries, people are more worried about risks related to experienced events. This is in line with the cognitive process known as the availability heuristic: individuals assess the risk associated with a given hazard based on how easily it comes to their mind. Epidemics, for example, are perceived as less likely and more impactful in Italy compared to Sweden. This outcome can be explained by cross-country differences in the impact of, as well as governmental responses to, COVID-19. Notwithstanding the ongoing pandemic, people in both Italy and Sweden are highly concerned about climate change, and they rank it as the most likely threat.

Effect of national and local lockdowns on the control of COVID-19 pandemic: a rapid review.

OBJECTIVES: to describe and compare the effectiveness of national and local lockdowns in controlling the spread of COVID-19. METHODS: a rapid review of published and grey literature on COVID-19 pandemic was conducted following predefined eligibility criteria by searching electronic databases, repositories of pre-print articles, websites and databases of international health, and research related institutions and organisations. RESULTS: of 584 initially identified records up to 5 July 2020, 19 articles met the inclusion criteria and were included in the review. Most of the studies (No. 11) used the reproduction  number (Rt) as a measure of effect and in all of them areduction of the estimated value at post-intervention period was found. The implementation of lockdown in 11 European countries was associated with an average 82% reduction of Rt, ranging from a  posterior Rt of 0.44 (95%CI 0.26-0.61) for Norway to a posterior Rt of 0.82 (95%CI 0.73- 0.93) for  Belgium. Changes in infection rates and transmission rates were estimated in 8 studies. Daily changes in infection rates ranged from -0.6% (Sweden) to -11.3% (Hubei and Guangdong provinces). Additionally, other studies reported a change in the trend of hospitalizations (Italy, Spain) and positive effects on the  doubling time of cases (Hubei, China) after lockdown. CONCLUSIONS: results of this rapid review suggest a positive effect of the containment measures on the spread of COVID-19 pandemic, with a major effect in  countries where lockdown started early and was more restrictive. Rigorous research is warranted to evaluate which approach is the most effective in each stage of the epidemic and in specific social contexts, in particular addressing if these approaches should be implemented on the whole population or target specific risk groups.

Olfactory and Gustatory Outcomes in COVID-19: A Prospective Evaluation in Nonhospitalized Subjects.

OBJECTIVE: To prospectively assess the rate and timing of recovery of olfactory (OD) and gustatory (GD) dysfunction in patients affected by COVID-19. STUDY DESIGN: Cohort study. SETTING: Population-based evaluation in a COVID-19 high-prevalence region. SUBJECTS AND METHODS: We analyzed the clinical course of OD and GD in a cohort of home-quarantined SARS-CoV-2-positive patients from Northern Italy. Physicians administered a survey-based questionnaire at recruitment (T0). During follow-up, patients responded to online dedicated surveys modulated according to symptoms at T0. RESULTS: A total of 151 patients completed the follow-up survey. OD and/or GD were observed in 83% and 89% of subjects, respectively. Resolution rates of OD and GD at 30 days from onset were 87% and 82%, respectively. Risk factors for late resolution were grade of dysfunction at onset (total vs partial), gender, and presence of nasal congestion. Three (2%) patients previously reporting complete resolution of symptoms complained of subsequent recurrence of OD and/or GD after a mean of 19 days from resolution of the previous episode. CONCLUSION: COVID-19-related OD and GD had high rate of resolution in the first month from onset of symptoms. However, in 10% to 15% of patients, these symptoms showed only partial improvement after this period.